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Immunotherapy CE/CME accredited

A visually engaging discussion designed to emulate a ‘live’ panel experience and provide clinicians with practical expert insights to address their clinical challenges. Useful tips below will show how to navigate the activity. Close

Immunogenicity of immune checkpoint inhibitors: What are the implications for clinical practice?

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Learning Objectives

After watching this activity, participants should be better able to:

  • Describe the experience of immunogenicity from the use of biologic therapies in chronic inflammatory diseases, and how this might inform the use of immune checkpoint inhibitors in oncology
  • Review the current data for the immunogenicity of immune checkpoint inhibitors and how anti-drug antibodies impact drug efficacy and safety
  • Discuss the potential clinical implications of anti-drug antibodies (ADA) in oncology and possible strategies for management

In this activity, three experts discuss recent data on the immunogenicity of immune checkpoint inhibitors and their clinical relevance for the treatment of patients with cancer, based on lessons learned from biologic therapies in rheumatology and inflammatory diseases.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

This activity has been designed to meet the educational needs of oncologists involved in the management of patients receiving treatment with immune checkpoint inhibitors.


USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity.  The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.


Prof. Peter Galle discloses: Advisory board, panel and consultancy fees from AstraZeneca, Bayer, BMS, Eisai, Guerbet Pharma, Ipsen, Lilly, MSD and Roche.

Dr Victor Moreno discloses: Advisory board or panel fees from Basilea, Bayer, BMS, Janssen and Roche. Research/grants from AbbVie, AceaBio, Adaptimmune, ADC Therapeutics, Aduro, Agenus, Amcure, Amgen, Astellas, AstraZeneca, Bayer Beigene BioInvent International AB, Boehringer, Boston, BMS, Celgene, Daichii Sankyo, Debiopharm, e-Terapeutics, Eisai, Exelisis, Forma Therapeutics, Genmab, GSK, Harpoon, Hutchison, Immutep, Incyte, Inovio, Iovance, Janssen, Kyowa Kirin, Lilly, Loxo, MedSir, Menarini, Merck, Merus, Millennium, MSD, Nanobiotix, Nektar, Novartis, Odonate Therapeutics, Pfizer, Pharma Mar, Principia, PsiOxus, Puma, Regeneron, Rigontec, Roche, Sanofi, Sierra Oncology, Synthon, Taiho, Takeda, Tesaro, Transgene, Turning Point Therapeutics and Upshersmith.

Dr Vibeke Strand discloses: Consultancy fees from AbbVie, Alpine, Alumis, Amgen Corporation, Aria, AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Celltrion, ChemoCentryx, Endo, Equillium, Ermium, Genentech/Roche, Gilead, Glenmark, GSK, Horizon, Inmedix, Janssen, Kiniksa, Kypha, Lilly, Merck, MiMedx, Novartis, Pfizer, Priovant, R-Pharm, Regeneron, Rheos, Samsung, Sandoz, Sanofi, Scipher, Setpoint, SOFUSA, Spherix and Tonix.

Content reviewer

Angela Massey Hill, Pharm.D., CPh, RPh. has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Adriano Boasso has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact



This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 17 November 2022. Date credits expire: 17 November 2024.

If you have any questions regarding credit please contact

This activity is CE/CME accredited

To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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Immunogenicity of immune checkpoint inhibitors: What are the implications for clinical practice?
0.75 CE/CME credit

Question 1/5
Which of these statements about non-neutralizing antibodies against biologic drugs is correct?

Non-neutralizing antibodies do not interfere with the binding of the biologic drug to its target and therefore they do not directly inhibit its pharmacodynamic activity; however, they can lower the drug’s systemic exposure by increasing the rate of drug clearance1 via immune complexes.2


  1. Gunn GR, et al. Clin Exp Immunol. 2016;184:137–46. 
  2. Strand V, et al. Nat Rev Rheumatol. 2021;17:81–97.
Question 2/5
Your patient with cancer has started therapy with an ICI. Based on data on the use of biologic therapies in chronic inflammatory diseases, which of these factors do you expect to influence the immunogenicity of the monoclonal antibody used for therapy?

ICI, immune checkpoint inhibitor.

The immunogenic response to biologic therapies can be altered by concomitant use of immunosuppressive and antiproliferative agents such as methotrexate. The immunogenicity of biologic can also be affected by treatment-related factors, such as the dose and route of administration; drug-related factors, such as biologic sequence and structure; and patient-related factors, such as genetics, disease type and activity.


Strand V, et al. Nat Rev Rheumatol. 2021;17:81–97.

Question 3/5
Your patient is a 55-year-old man with a solid tumour and is enrolled in an open-label phase I clinical trial testing atezolizumab monotherapy in a new indication. His blood work has recently shown the presence of ADAs against atezolizumab. Based on available data, how would you expect this result to affect response to therapy?

ADA, anti-drug antibody.

A meta-analysis of 11 trials including 7,303 patients with solid tumours (lung, breast, renal, liver and urothelial cancers) found that the efficacy of atezolizumab was similar between patients who tested positive or negative for ADAs.


ADA, anti-drug antibody.


Peters S, et al. Clin Transl Sci. 2022;15:141–57.

Question 4/5
Based on clinical trial data, what incidence of ADAs would you expect to see in your patients who are receiving treatment with durvalumab?

ADA, anti-drug antibody.

The maximum reported treatment-emergent ADA positive rate for durvalumab is 3%.


ADA, anti-drug antibody.


FDA. Durvalumab PI. Available at: (accessed 19 October 2022).

Question 5/5
Your patient, a 50-year-old male with a solid tumour receiving ICI therapy for the past 6 months, has shown tumour progression at his follow-up last week. What would you do to factor ADAs into the clinical decision-making process for this patient?

ADA, anti-drug antibody; ICI, immune checkpoint inhibitor.

ADA measurement is not standardized nor routinely conducted in oncology clinical practice; their analysis is generally conducted only in the early stages of drug development. 


ADA, anti-drug antibody.


Borregón M, et al. Cancer Chemother Pharmacol. 2022;89:577–84.

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